Delgocitinib Cream Delivers Meaningful, Long-Term Symptom Improvement in Patients with Chronic Hand Eczema

Nearly half of patients treated with delgocitinib cream for 16 weeks achieved significant improvements in symptoms of chronic hand eczema (CHE) and quality of life, and nearly a third of those enrolled in the extension trial maintained the improvements 8 weeks after stopping treatment, according to data presented at the 2025 Fall Clinical Dermatology Conference in Las Vegas, Nevada. 

CHE is a common, chronic inflammatory skin disease that lasts at least 3 months or recurs at least twice within a year. CHE has a variable presentation that includes dry, scaly, erythematous, and pruritic hand lesions, which can be accompanied by vesicles, edema, hyperkeratosis, and erosions. Many patients with CHE experience a high burden of disease, which can adversely affect their quality of life, productivity, and mental health. 

Delgocitinib, a pan-Janus kinase (JAK) inhibitor that blocks all four members of the JAK family (JAK 1-3 and tyrosine kinase 2), is the first topical therapy specifically approved for individuals with moderate-to-severe CHE. Delgocitinib suppresses the overactivation of the skin’s inflammatory response and may improve skin barrier function by suppressing the JAK/Signal Transducer and Activator of Transcription 3 (JAK/STAT3) signaling pathway, which plays a key role in the pathogenesis of CHE. 

In the DELTA 1 and DELTA 2 phase 3 clinical trials, delgocitinib achieved significant improvement in all efficacy endpoints versus cream vehicle in adults with moderate-to-severe CHE. Participants were assigned to receive either delgocitinib cream 20 mg/g or cream vehicle twice daily for 16 weeks. The primary endpoint reported at 16 weeks was treatment success, measured by an Investigator’s Global Assessment for Chronic Hand Eczema (IGA-CHE) score of 0 (clear) or 1 (almost clear, defined as barely perceptible erythema), with at least a two-step improvement from baseline. At week 16, a greater proportion of participants treated with delgocitinib cream (24.3%) achieved IGA-CHE treatment success compared with those assigned to cream vehicle (8.4%) in both trials (Bissonnette R et al. Br J Dermatol 2024; 191: Supplement 2; ljae266.032). Participants who completed DELTA 1 or 2 had the option to enroll in the DELTA 3 extension trial, which was designed to evaluate the long-term safety and efficacy of delgocitinib cream. During the extension phase, participants with IGA-CHE scores ≥2 received delgocitinib cream until their symptoms resolved. DELTA 3 showed that CHE symptoms further improved with delgocitinib cream 20 mg/g over the 36-week extension period, without any emerging safety concerns. 

The post-hoc analysis presented in a poster session at the Fall Clinical Dermatology Conference revealed that a subgroup of participants treated with delgocitinib cream achieved a particularly strong response to the treatment, which was maintained over 16 weeks in the DELTA 1 and DELTA 2 trials, and, in some participants, for several weeks after stopping treatment. 

“Super-response” was defined as either deep, consistent, and/or maintained treatment response. Nearly 50% of patients treated with delgocitinib cream in the DELTA 1 and 2 trials achieved at least one treatment outcome, such as little-to-no itch or pain, or minimal-to-no impact on quality of life at week 16. Approximately one-quarter of the delgocitinib cream-treated patients consistently showed clinically meaningful improvements in itch, pain, or disease severity across all visits at weeks 4, 8, 12, and 16. Of patients who enrolled in the DELTA 3 extension trial, approximately 33% of participants who achieved IGA-CHE scores of 0 at week 16 still maintained IGA-CHE 0/1 scores after 8 weeks off treatment and 15.7% maintained IGA-CHE 0/1 scores after 16 weeks off treatment. 

The strong response documented in this subgroup of patients treated with delgocitinib cream, dubbed “super responders,” highlights the potential role of delgocitinib cream in achieving long-term control of CHE symptoms.